Editor-in-Chief, Deputy Editor 2017-2019

 

Editor-in-Chief:

Tom MOREELS

 

Deputy Editor:

Nicolas LANTHIER

 

Case series



A new technique for endoscopic treatment of gastric phytobezoars : fragmentation using guidewire


Price: €10,00

Background and Study Aims : Bezoars result from accumulation of indigestible materials in the gastrointestinal tract and often occur in the stomach. In this study, we evaluated the use of guidewires in patients with gastric phytobezoars (PBs) as a new method for PB removal and examined the safety of the procedure. Patients and Methods : Between February 2009 and January 2013, we analyzed data from 11 patients with gastric PBs. We fitted a transparent cap to a standard endoscope (EG450WR5, Fujinon), and a 0.025 inch guidewire was passed through the standart endoscope. PBs were surrounded by a loop in the guidewire and destroyed. After 2 weeks of treatment, patients were re-evaluated for effectiveness. Results : PB fragmentation time was 5-11 minutes. In five patients with a history of gastric surgery, we needed an additional 16-28 minutes for removal of the fragments. In six patients additionally treated with enzymatic degradation after the breaking procedure, PBs completely disappeared within 2 weeks. There were no complications during the procedure. Conclusions : The guidewire and fragmentation procedure for PBs is an efficient and reliable method. When combined with enzymatic degradation, PBs can be managed quickly and effectively. (Acta gastroenterol. belg., 2014, 77, 389-392). [Product Details...]



Long-lasting tumour response to sorafenib therapy in advanced hepatocellular carcinoma


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The multi-kinase inhibitor sorafenib still remains the only approved agent for advanced HCC. Its benefits typically involve disease stabilisation, whereas an induction of response is rare. We report a series of five cases with extraordinary response to sorafenib. For two patients complete response to sorafenib was reported with a recurrence-free survival of 51 and 21 months. In another HCC patient pretreated with transarterial chemoembolisation (TACE) sorafenib treatment resulted in a complete response with no evidence of disease 18 months after first diagnosis. In patient 4 with unresectable HCC and sorafenib therapy secondary resectability and subsequent liver transplantation was achieved. Patient 5 had stabilised disease for 48 months after TACE and sorafenib treatment. Sorafenib may be very potent in individual patients. Excellent interdisciplinary strategies are required to achieve best results. There is an urgent need of predictive biomarkers to identify HCC patients that will benefit the most. (Acta gastroenterol. belg., 2014,77, 386-388). [Product Details...]


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